Robot-assisted surgery: applications in urology

Abstract

Abstract:The past decade has seen a dramatic shift in the surgical management of certain urologic conditions with the advent of a robotic surgical platform. In fact, the surgical management of prostate cancer has seen the most dramatic shift, with the majority of cases now being performed robotically. Technical refinements over the years have led to improved outcomes regarding oncologic and functional results. Recently, robotic surgery has also been utilized for the surgical management of bladder cancer, renal cancer, and other benign conditions. As further experience is gained and longer-term outcomes are realized, robotic surgery will likely play an increasing role in the surgical management of many urologic conditions. Keywords: robot-assisted surgery, robotic surgery, cystectomy, prostatectomy, partial nephrectomy Technological advances continue to impact the modern practice of urology, none more so in recent years than the development of robotic surgery. Since the first publication of a series of patients undergoing robot-assisted radical prostatectomy in 2001, the field has seen a dramatic increase in the use of robotic surgery for urologic procedures. In fact, more than 60,000 robot-assisted radical prostatectomies were performed last year alone.The minimally-invasive nature of these procedures allows for better precision, decreased blood loss, shorter hospital stay, decreased morbidity, and shorter convalescence while preserving functional and oncologic outcomes. Additionally, the application of robotic surgery has spread beyond radical prostatectomy to include radical cystectomy, nephrectomy, partial nephrectomy, adrenalectomy, and other upper urinary tract surgery (pyeloplasty, ureteral reimplant, etc.). Robotic surgery has even seen dramatic growth in pediatric urologic applications.In this review, we will attempt to highlight robotic surgical applications to various urologic procedures and discuss the recent advances in these procedures. Robot-assisted radical prostatectomyThe surgical treatment of prostate cancer has seen a dramatic shift over the past decade. Minimally-invasive approaches to prostate surgery were slow to gain a foothold until the development of a robotic surgical platform. Prior to this development, laparoscopic radical prostatectomy was performed, but only by advanced laparoscopic surgeons. This method was undoubtedly limited by a steep learning curve and the arduous tasks of the procedure, including intracorporeal suturing. The robotic platform takes